The Closing Group: Therapeutic Recreation for Nursing Home Residents with Dementia and Accompanying Agitation and/or Anxiety
Long-term care residents who have a dementia diagnosis could account for as much 50% of a nursing home’s population. Often residents with dementia experience a distressing behavioral symptom that affects the resident experiencing the symptom(s), other nursing home residents, visitors, and staff. The Closing Group intervention was developed as a nonpharmacological alternative that aims to reduce agitation and anxiety, increase socialization, decrease restraint use, and decrease antipsychotic drug use for selected residents with a dementia diagnosis. The program was based on an understanding of the contributing factors to agitation and anxiety, the nursing home environment as it relates to behavior, and the offering of resident-driven recreational activities. The purpose of this 2-year study was, with use of multiple measures, to examine the extent to which the Closing Group intervention has met its goals. A sample of 16 long-term care residents was offered attendance at the group. Findings in the area of reducing agitation and anxiety were encouraging to the extent that further study with larger samples is needed.
Increasing evidence suggests that performance of the instrumental activities of daily living (IADL) can be impaired at the mild cognitive impairment (MCI) stage. Our study aimed at investigating the profiles of functional impairment in Chinese subjects with MCI.
Subjects with MCI were categorized into single-domain amnestic MCI (a-MCI) (n = 54) and multiple-domain amnestic MCI (md-MCI) (n = 93) groups. Their functional scores of Disability Assessment of Dementia (DAD) were compared with those of cognitively normal elderly controls (NC) (n = 78) and those with mild Alzheimer’s disease (AD) (n = 85).
Subjects with md-MCI had intermediate performance in IADL between the NC and those with mild AD. Subjects with a-MCI had functional scores similar to those of normal controls. Age, education, and global cognitive test scores were not associated with functional scores in MCI subjects.
Our results demonstrated that Chinese older persons with md-MCI had impairment in IADL, as compared to NC and subjects with a-MCI. This finding suggests that assessment of IADL should be incorporated in the clinical evaluation of MCI.
Counseling Boosts Alzheimer’s Caregivers’ Health
Title: Counseling Boosts Alzheimer’s Caregivers’ Health
Category: Health News
Created: 9/7/2007 2:00:00 AM
Last Editorial Review: 9/7/2007
Impact of a Multimodal Rehabilitative Intervention on Demented Patients and Their Caregivers
Alzheimer’s disease is becoming a social, political, and economic issue as a result of both the growing number of people affected and the enormous economic, social, and emotional costs involved in caring for Alzheimer’s patients. The aim of this study is to evaluate the effects of a multimodal intervention program for patients with Alzheimer’s disease and their caregivers. The study was conducted on a sample of 32 subjects: 16 Alzheimer’s patients and their caregivers. The results obtained after the multimodal rehabilitation program showed that the Alzheimer’s patients had a more stable cognitive status and improved mood. Regarding the psychoeducational program, the results demonstrate the efficacy of such interventions in terms of increasing and preserving the caregivers’ coping skills and enhancing their perception of the value of support groups.
Six persons in the early to middle stages of dementia (”leaders”) were trained in Resident-Assisted Montessori Programming (RAMPTM) to lead a reading activity for 22 persons with more advanced dementia (”participants”) in an adult day health center (ADHC) and a special care unit (SCU) in a skilled nursing facility. Researchers assessed the leaders’ abilities to learn and follow the procedures of leading a group, as well as their satisfaction with their roles. In addition, participants’ engagement and affect were measured, both during standard activities programming and during client-led activities. Results of this study suggest that persons with dementia can indeed successfully lead small group activities, if several important prerequisites are met. Furthermore, the engagement and affect of participants was more positive in client-led activities than in standard activities programming.
Health Tip: Feeling Forgetful?
Title: Health Tip: Feeling Forgetful?
Category: Health News
Created: 7/24/2007 2:00:00 AM
Last Editorial Review: 7/24/2007
The Genetics of Alzheimer’s Disease
The genetics of Alzheimer’s disease is produced by 3 essentially interactive gene groups: (1) APP and presenilin 1 and 2; (2) APOE E2, E3, and E4; (3) genes on chromosomes 9, 10, 12, etc. If any gene in (1) mutates, beta amyloid (Aß) increases sharply beyond what the genes of (3) can remove, with early-onset Alzheimer’s disease the result. With retention of Aß by E4 in (2), Alzheimer’s disease might result even though (1) and (3) are normal. If any gene in (3) mutates, the level of Aß will rise, but because many genes are involved in Aß removal, late-onset Alzheimer’s disease would be detected only eventually.
Curry Spice May Counter Alzheimer’s
Title: Curry Spice May Counter Alzheimer’s
Category: Health News
Created: 7/17/2007
Last Editorial Review: 7/17/2007
Telehealth Home Monitoring of Solitary Persons With Mild Dementia
Medication safety is a special concern for the 30% to 40% of dementia patients who live alone at the time of diagnosis, and it plays an important part in relocation decisions. Televideo monitoring could improve medication self-administration accuracy and improve mood for persons with mild dementia who live alone or spend a significant amount of their day alone. The authors used 2-way interactive video technology to monitor medication compliance of 8 persons with mild dementia. They conducted more than 4000 contacts with these persons and found adequate technical outcome in 82% of calls. End medication compliance was 81% in the video-monitored group compared to 66% in the controls (P < .05). Comparison of compliance from initial to end ratings revealed that video-monitored participants’ compliance remained stable while unmonitored patients’ compliance fell 12 percentage points, consistent with expectations for dementia. This difference was also significant. Quantitative and qualitative outcome data from this project are presented.